Hormonal therapy associated with Gastroesophageal Reflux Disease in menopausal women

Hormone therapy (HT) is commonly used to boost hormone levels and relieve some of the symptoms of menopause. Female hormones and hormone replacement therapy (HRT) are thought to play a role in gastroesophageal reflux disease (GERD). Pregnancy, menopause, and HRT have all been reported as risk factors for GERD.

Very little is known about GERD and its the association between hormone therapy (HT) and GERD in postmenopausal women.

Researchers in the current meta analysis investigated the association between ever or current menopausal HT use and GERD using a systematic review and meta-analysis and found that there is a significant association between ever or current HT use and GERD. The results has to be considered carefully due to small number of included studies and high heterogeneity. The study is published in Menopause journal.

Researchers conducted a pooled analysis of five studies found a significant direct association between estrogen use and GERD (aOR, 1.41; 95% CI, 1.16-1.66; I2 = 97.6%), and progestogen use and GERD (two studies: aOR, 1.39; 95% CI, 1.15-1.64; I2 = 0.0%). Studies published between 2008 and August 31, 2022, were pooled using a DerSimonian and Laird random-effects model, and outcomes were reported as adjusted odds ratios (aOR) with a corresponding 95% CI.

The key findings of the study are

• The use of combined HT was also associated with GERD (1.16; 95% CI, 1.00-1.33; I2 = 87.9%). Overall, HT use was associated with 29% higher odds for GERD (aOR, 1.29; 95% CI, 1.17-1.42; I2 = 94.8%).

• The large number of pooled participants, differences in study design, geography, patient characteristics, and outcome assessment resulted in significant high heterogeneity.

The researchers concluded that “There is a significant association between ever or current HT use and GERD. However, the results should be interpreted with caution, given the small number of included studies and high heterogeneity. This warrants careful evaluation of GERD risk factors when prescribing HT to reduce the risk of potential GERD complications.”

Reference: Aldhaleei, Wafa A. MBBCh, MSc, MPH1; Bhagavathula, Akshaya S. PharmD, PhD2; Wallace, Michael B. MD, MPH3,4,5; DeVault, Kenneth R. MD3; Faubion, Stephanie S. MD, MBA, NCMP6,7. The association between menopausal hormone therapy and gastroesophageal reflux disease: a systematic review and meta-analysis. Menopause ():10.1097/GME.0000000000002214, June 27, 2023. | DOI: 10.1097/GME.0000000000002214.